Circumcision instrument



July 21, 1953 H. BRONSTEIN 6,0

CIRCUMCIS ION INSTRUMENT Filed Feb. 19, 1952 2 Sheets-Sheet l HARRYBRON-S TE IN 24 x f BY I T MW ATTORNEY I I i A: INVENTOR.

y 21, 1953 H. BRONSTEIN 2,646,047

CIRCUMCISION INSTRUMENT I Filed Feb. 19, 1952 2 Sheets-Sheet 2.

ATTORNEY Patented July 2 ,1953

rst? UNITED STATES PATENT OFFICE Harry Bronstein, Brooklyn, N. Y.

Application February 19, 1952, Serial No. 272,381

This invention relates to a circumcision instrument and a method ofcircumcision which method will conform to the ritualistic requirementsof Hebraic Law.

Ritualistic circumcision is of ancient origin and for centuries wasperformed by manually separating the foreskin from the glans penis,cutting off the foreskin above the corona of the penis, and removing theblood which necessarily would flow from the wound. At one time, due tothe advance of medical science, it was proposed to employ the clampingtechnique for ritualistic circumcision but a reading of the ritualisticrequirements disclosed that such circumcision would be improper.

A study of the appropriate religious requirements discloses that theritual provides that blood must flow during the removal of the foreskinfrom the penis and that therefore, since the conventional clampintechnique produces haemostasis, such circumcision cannot be approved.However it is also true that circumcision performed with the aid of ahaemostatic clamp prevents the relatively infrequent hemmorhages thatsometimes occur in the child after circumcision.

Briefly stated my method comprises separating the foreskin from theglans penis, inserting the foreskin into a recess provided within aclamp,

with or without lubrication f the foreskin, applying pressure to theforeskin sufiicient to hold it firmly to the clamp without cutting offthe blood supply, and thence increasing the pressure to provide completehaemostasis. The pressure is generally applied for a period of from oneto ten minutes and after that time is released.

It is also preferable, in order to allow the foreskin to slide easilyinto the recess, to make adorsal slit in the foreskin prior to itsinserting into the recess, at a point'midway between the tip of thepenis and the corona.

The invention also includes the necessary circumcision clamp which isrequired to carry out the above mentioned method, which clamp is'ofnovel construction.

The invention will be further described by reference to the accompanyingdrawings which are made a part of this specification.

Fig. 1 is a front View of the novel circumcision clamp used to carry outthis invention.

Fig. 2 is a top View of the novel circumcision clamp used to carry outthis invention.

Fig. 3 is a sectional view of the said clamp taken on lines 3-3 of Fig.2.

Fig. 4 is a sectional view of the said clamp taken on lines 4-4 of Fig.3.

Fig. dis a sectional view of the clamping mem- 1 Claim. (01. 128346) r 2ber of the clamp of this invention taken on lines 55 of Fig. 1.

Fig. 6 is a sectional view of the clamping member of the clamp of thisinvention taken on lines 66 of Fig. 3.

Fig. '7 is a sectional view of the holding member of the clamp of thisinvention taken on lines l1 of Fig. 3.

Fig. 8 is a top view of the portion of the clamp of this invention whichis provided with a recess.

Figs. 9, 10 and 11 are front views of an alternative form of clamp ofthis invention showing the three positions of the holding member whichare utilized in carrying out the novel method of circumcision describedin this invention.

Fig. 12 is a front view of an alternate form of the portion of the clampof this invention which is provided with recesses and which may be used7 in place of the form shown in Fig. 8..

Fig. 13 is a sectional view of the alternative form of the portion ofthe clamp of this invention provided with recesses shown in Fig. 12taken on lines I3l3 of Fig. 12.

Referring now to the principal form of the clamp of this invention shownin Figs. 1 to 8 there are provided base member which bears offsetportion 2 I in the front thereof. Base member 20 is flattened upon itsbottom portion 22 so that the entire clamp member may stand of itselfwhile being used. Horizontal member 23 extends forwardly from offsetportion 21 and is pref erably secured to offset portion 2| by screwmember 24. Horizontal member 23 is provided with recess 25, which ispreferably outwardly tapering at a preferred angle of 82 degrees.Clamping member 26 is adapted to fit into recess and is preferablyformed with a stem portion 27 and an outwardly tapering portion 28. Theoutwardly tapering portion of clamping member 26 is preferably providedwith a hollow portion 29 so that the sides 30 and 3! may fit over theglans penis during the use of this device as will be subsequentlyexplained;

Stem portion 21 is pivotally secured to upper member 32 by means ofpivot 33 and recess 34. Spring member 35 is provided to hold base member 20 and upper member 32 apart but the out ward pressure exerted byspring member 35 is counteracted by holding member 36 which is providedwith grooves 31. Upper member 32 terminates in a point 38 which isadapted to fit into grooves 31.

Preferably also holding member 35 is held in a forward position bytension provided by spring 39 whichis secured to base member 20.

Holding member 3:6 is secured to base member 29 by pin 40 which isdisposed in a recess 4| provided. in base member 23.

It is clear that when upper member 32 is depressed point 33 forcesholding member 36 back against the pressure of spring 39 and that point38 will be held when pressure is released within grooves 31. Furthermoreupper member 32 pivots about pivot 42 when being depressed and raisesclamping member 26 so that outer sides 43 and 44 bear against recess 25.The grooves 31 are marked with the numerals l, 2, and 3 and cause thefollowing relationship of clamping member 26 with respect to recess 25.

When point 38 is held within groove 31 marked 1 clamping member 26 is inspaced relationship relative to recess '25 (as indicated by thealternative construction of Fig. 9).

When point 38 is held within groove 31 marked 2 clamping member 2-5 isin abutting relationship relative to recess 25 (as indicated by thealternative construction of Fig. However the construction'of the clampembodies some play so that when a foreskin is also placed in recess thepressure exerted by clamping member 26 upon it will be sufiicient tohold it rigidly in place but not sufficient to cut off the blood supply.

When point 38 is held within groove 31 marked 3 clamping member 26 iscompressed against the sides of recess 25 so that a great amount ofpressure is produced causing complete haemostasis when a foreskin isplaced within said recess.

Fig. 12 shows an alternate type of horizontal member provided with a arecess that can be used in the clamp member of this invention. Thisalternate structure is placed in position under screw member 24 in placeof horizontal member 23. The alternate member 49 is provided with aplurality of recesses 50 which are of differing sizes and are preferablyoutwardly tapering. Recesses 56 are also provided which are adapted toengage pin member (not shown) in front of screw member 2A. In use withthis modification a clamping member of proper size to fit in the recessselected and to fit over the glans penis is procured.

The recess to be used is placed directly forward of screw member 24 bypivoting horizontal member 49 about screw member 24.

Figs. 9, 1'0, and 11 illustrate the manner in which the circumcisionprocess of this invention is carried out. These figures show the sametype of clamp as shown in Figs. l-8 but with still another alternateform of horizontal member provided with a recess. As shown in thesefigures horizontal member 68 is formed with a thickened forward portion6i which is provided with recess 62 into which clamping member 26 fits.Sides 63 and 64 of recess '62 are outwardly tapering. This constructionallows the foreskin of the penis to be circumcised to fit easily withinrecess 52.

It is also pointed out that horizontal member 23 and clamping member 2'5in the principal form of the invention are removable and while the lowerportion of clamping member 26 and the recess provided in horizontalmember '23 must be equal in size, the size of the parts selected will bedetermined by the size of the penis to be circumcised.

The novel method of circumcision utilizing the apparatus of thisinvention will now be described in detail.

The child to be circumcised is prepared in any number of conventionalmanners one of which is described by F. M. Al Akl, M. D. in ClinicalSymposia, volume 2 Number 7. The adhesive mucosa is loosened with ablunt probe, the foreskin and mucosa are then clamped with twohaemostats on the right and left. A dorsal slit is made in the foreskinwith blunt probe scissors halfway between the tip of the foreskin andthe corona. This last step, while not strictly necessary, aids inpermitting the clamping member to fit over the glans penis as will besubsequently explained. The foreskin and the mucosa are pulled down withthe haemostats off the glans penis until the corona is visible. Thecorona is then cleaned so that all smegma is removed and the corona isfree from adhesion of the mucosa. The foreskin and mucosa are thenpulled back over the glans penis with the haemostats.

A clamping member 26 of size to fit over the glans penis as shown inFig. 9 is selected and the proper size of horizontal member 6!! bearinga recess of size to accommodate clamping member 26 is secured to theclamp by means .of screw member 2d and pin member Before clamping member26 is secured to the clamp, however, it is held in the hand and forcedinto the slit in the foreskin and mucosa previously made. The foreskinand clamping member 26 is then held in the hand, the instrument lockedinto number 1 position and clamping member 25 is placed up throughrecess 62 with the stem portion forward. In order to do this clampingmember 23 is preferably held on a slant and recess 62 lubricated inorder to allow the foreskin to slide through easily. Clamping member 28is now straightened out and pin member 33 engaged with member 32. Theinstrument is now transferred to the other hand, the thumb is held overthe top of the stem of clamping member 26 and the foresln'n and mucosa65 pulled through recess 62 to the proper size With the aid of ahaemostat. At this point the hollow portion of clamping member 26 fitsover the glans penis 65 and extends practically to the corona 61. Whenthe operator feels the proper length of foreskin is exposed he then setsthe instrument to number 2 position (Fig. 10) at this point the foreskin65 is held firmly by the clamp but circulation is still present in theblood vessels supplying blood to the foreskin. The foreskin is thenremoved and the instrument set in number 3 position Where the foreskinis compressed producing complete haemostasis. The clamp is left in thisposition for a period of from one to ten minutes.

The foregoing specific embodiments of this invention as shown in theforegoing specification are for illustrative purposes and for purposesof example only. Various changes and modification can obviously be madewithin the spirit and scope of this invention and will occur to thoseskilled in this art.

I claim:

A circumcision instrument comprising a flat base member upon which theinstrument may stand of itself, said base member bearing an offsetportion in the front thereof, a forwardly extending horizontal membersecured to said offset portion, said horizontal member being pivotallysecured to said offset portion and bearing a plurality of outwardlytapering recesses, an outwardly tapering hollow clamping member adaptedto fit within one of said recesses, an upper member pivotally secured tosaid clamping member and to said offset portion, said upper member beingcapable of determining the relationship between said clamping member andone 5 of said recesses, a spring member adapted to exert outwardpressure upon said base member and said upper member, and a holdingmember secured to said base member capable of holding said base memberand said upper member in place against the outward pressure exerted bytion compressing said clamping member against the sides of one of saidrecesses.

HARRY BRONSTEIN.

References Cited in the file of this patent UNITED STATES PATENTS NumberName Date 662,178 Truax Nov. 20, 1900 2,533,373 Hinckley Dec. 12, 1950OTHER REFERENCES Gomoco Clamp Advertisement, Form 4, Received in PatentOflice April 25, 1935. Copy in Division 55.

